Diving and Beta Blockers?

[flygirl74]

Hi all!! I'm new to diving and this forum. Just two weeks ago I finished my Open water with no problems. Yesterday I went out for a couple dives and after the first tank dive I felt tired and a little dizzy. It past and I finished up the day with a second dive. When I got home I checked my BP and I was 99/69 with a heart rate of 76. A little background on me. I'm a 38 year old female. I've had very high BP over the last few of years. I also have Klippel-Feils and had surgery many years ago for Sprengel's Deformity. I'm active and not over weight. I've been on many different BP medications, but as of 6 months ago I'm on Carvedilol 25mg twice a day and half a Lorsartan-HCTZ 100-12.5mg. I'm guessing that I was a little dehydrated in between dives causing me to bottom out and get a little dizzy. My Cardiologist (who is a genius) is not a sports guy and I was just curious if I should be worried about diving. I know Carvedilol is a beta blocker and the Lorsartan HCTZ is a combo pill with diuretic. My BP is the best it's been since my late 20's, but occasionally I do bottom out mainly if I get overheated. Is there a different combo of meds I should talk to the Dr. about? When diving should I leave out the Lorsartan or cut back on the Carvedilol? Thanks!​

 

[TSandM]

Beta blockers, as a class, tend to limit heart rate. This can blunt the reflex increase in pulse that occurs when venous return to the heart is decreased, as it is with any kind of volume depletion. It can also limit the cardiac response to exercise. Beta blockers, as a class, are low on the list of medications of choice for any athlete.

That said, hypertension is a lifetime disease, and it does damage over a long period of time. You need control, and if you are one of those folks who has been tried on a variety of medications, and this is all they've found that works, you will have to arrange the other parts of your life around your meds, rather than the reverse. For diving, this would definitely mean diligent attention to hydration, since immersion diuresis, which is inevitable, will volume deplete you at the end of a day. It might also mean avoiding diving locations where high currents or other athletic challenges were likely.

I would not alter your antihypertensive regiment for a diving day. Beta blocker withdrawal can produce much higher blood pressures than you would have, even with your baseline high blood pressure.

I did a little reading about Klippel-Feil, since it wasn't something with which I was very familiar. The articles speak of abnormalities of the kidney related to the syndrome -- have your doctors looked into a renal cause of your hypertension?

 

[flygirl74]

One of the reasons I think my Cardiologist is a genius is because when I first met him he knew exactly what Sprengel's and Klippel Feil was. It's not very common and I'd never met anyone that knew it before. Along with the echocardiogram he ordered he also ordered a MRI/MRA of my kidneys. The echo was good, but the MRI came back as bilateral renal stenois. I was so excited thinking that I would be cured of my BP problems with a simple procedure. No such luck. When they were doing the arteriogram the doctor realized what was seen in the MRI was an "artifact". After that I've pretty much have resigned myself to the pills.

As for the Klippel Feil in simple terms I've got a real mess in my neck that will become worse with age. I now have a wonderful cervical spine Dr. who will see me each year to watch the progession and help me with it. One of the reasons I really want to get into diving is because I'm an avid snow skier, but the spine Dr. says I need to be super careful or possibly give it up in the future. I'm thinking that diving may take the place of all the skiing I do in the future.

I know that I'm going to have take BP meds forever, but if there is something that will be better for diving I'll talk to the Dr. about it. Is there such a thing as a dive Doctor or specialist? If so where would I find one? I've really had a good time doing my dive classes and my dive yesterday. I'm headed to the Keys next week for a week of diving and hope to fall in love with the sport.

 

[spectrum]

There are dive savy doctors out there. My wife has stumbled onto a few who are divers so they at least have a common frame of reference and they understand the sport. Others if not specialist do have a special focus. This board and contacting DAN are 2 ways to find those near you.

Pete

 

[flygirl74]

There are dive savy doctors out there. My wife has stumbled onto a few who are divers so they at least have a common frame of reference and they understand the sport. Others if not specialist do have a special focus. This board and contacting DAN are 2 ways to find those near you.

Pete

Thanks!!

I'm more then willing to listen to anyone that has good advice. I've seen a lot about DAN and I'm thinking about calling Monday. I'm also going to call my Dr. once again.

 

[Agility]

using practically the same medication (candelsartan insteaed of losartan) I know I have to keep away from currents I would have to swim against and I always do "2-tank dives" one filled with gas and one with water ;-) diuresis is a problem (in a dry suit) so it sometimes limits my dive time.
If I do not feel the urge after 45 minutes, I know I need to drink more.

 

[GrumpyOldGuy]

None-medical observation.

I have been on beta blockers (Atenolol) for 15 years and have no side effects, in fact the doc had to increase the dose to get my BP to the desired 110/75. It's an old medication and there are supposedly better ones out there but it works for me, so I leave well enough alone.

I have several friends who tried it at times, some had to really work to get the right level so it did not slow them down, others failed and went on to different medications that worked better for them.

My point being different people react differently to the same medications, you (and your doc) have a lot of choices and I don't think long term you should settle for a medication that makes you dizzy (that outright scary to me) or slows you down physically. Keep digging, there is bound to be a better solution.

 

[flygirl74]

Thanks to all who posted and especially those that take similar meds. The internet is a wonderful place to research, but sometimes it can make one over think and stress things. Had a nice long chat with my Cardiologist's nurse about my worries and how my meds have been. Happily I can report that I'm getting to cut back on some of my Carvedilol!! My Cardio Dr. feels very comfortable with me and SCUBA. I'm so looking forward to our first big SCUBA trip. Also contacted DAN and was given a list of Dr. if I feel like I need it in the future. Thanks again to all!! Now I just need to figure out what to pack!

 

[clgsamson]

Don't forget your C-Card. Enjoy!